Dr. Carlin Vickery Speaks at Fab Over 50

Dr. Carlin Vickery speaks at a Fab Over 50 event on having great breasts after the age of 50. In this presentation Dr. Carlin shares patient results by providing before and after pictures from different types of breast surgeries including breast lifts, implants and reductions.

Video transcript:

HOST:
All right, well let's get started, I would like to introduce Dr. Carlin Vickery. She ranks as one of the city's top plastic surgeons. At a time when female surgeons were a rarity, Dr. Vickery followed an arduous path to become one of the first woman to achieve success as both a general and plastic surgeon. Along with her partner at Fifth Avenue Millennium Aesthetic Surgery she forms New York's longest tenured microsurgical team receiving breast reconstruction referrals from across the country. Dr Vickery performs a full range of cosmetic breast and body contouring procedures at her practice.

Dr. VICKERY:
Thank you. We are here to talk about my favorite subject which is breasts and hopefully it will resonate with a few of you here. I really think that women after 50 should enjoy their bodies and I feel as though it’s not just how you look but also how you feel. And when women go past the age of 50 there frequently are metabolic changes due to hormones which change our muscular skeletal system and so if our breasts are not well supported on our chest walls, frequently women have a great deal of dragging on their upper bodies which really inhibits their daily life, their ability to stay fit and ultimately I think the quality of their life over the next 20 or 30 years.

I wanted to start with this picture from the back because I think it really demonstrates what happens when a woman's breasts are not well supported. If you look at this woman's shoulders you can see that from her brassieres, over many years, she has really developed tremendous dense. I don’t have a pointer but I think it’s fairly obvious if you look along the upper contour. And every day, 24 hours a day if she is wearing the wrong bra, she’s got gravity pulling and creating pressure right in that spot and if you look adjacent to where the bra mark is towards her neck you will also see that she has very prominent trapezius muscles and those are the muscles that are helping her to hold those breasts. So if you can imagine the gravity that’s pulling down, she is walking around like this all the time and that’s why those muscles have gotten so large and that is why this patient is chronically complaining that she has neck, shoulder and back pain as well as a headache and that’s just no way to live and there is something we can do about it. I can tell you the number of women who come in and they’ve had their children, they’ve been busy taking care of everybody else in their life and now they finally get into my office and they say, “you know doctor I really hope that you don’t think I’m being vain but this is really bothering me, it’s bothered me my whole life and I’d really like to do something about it but I feel badly”. And I point out to them that this isn't just the cosmetic surgery, that this is also an investment in their wellbeing over time, because they’re going to relieve the pressure in their upper back so that they can live a long and healthy life for the remainder of their 20, 30 or 40 years.

So, here is a typical breast reduction patient and there is a pre-operative and post-operative photograph and she is quite large, not everybody is this large, obviously this woman is quite large. Those breasts are hanging down almost to her belly button. She probably has an equivalent of 7 pounds in each breast that's dragging on her neck, so that is total of about 14 pounds and I guarantee you if you took anybody and took 14 pounds tied it around their neck , they wouldn't be standing up straight very long and they'd be complaining very rapidly. You can see her post-operatively and you can see that now her breasts are considerably smaller and they are higher on her chest wall and she’s not the slimmest person on the planet but she is proportionate now. What I love about this post-operative picture is that you can see from her tan lines that she has been in bathing suit, and she is now out and enjoying her life and instead of just wearing a shirt and not being active and not being able to enjoy the beach or being outside, she’s got her bathing suit on and she has really embraced life.

The next picture shows the same patient from the side and even more dramatically you can see that the breast instead of looking towards the floor is now looking appropriately horizontally out straight and it’s perky. And, so now her.... instead of people seeing her as just an amorphous blob of flesh between her breasts and her abdomen she actually has some definition and looks and feels better.

The second patient is not dissimilar, she is little bit smaller. Her breasts aren't quite as large, I would say they are about a third of the way, but again they demonstrate the classic picture that we so frequently see where the breasts are more resting on her abdomen than on her chest wall and creating that drag on the upper chest wall. The picture on the left side post-operatively is at about 2 or 3 years. The scars that she has which were originally around her nipple and there is a straight line scar going down her breast and little tiny scar hidden under the breast, have really healed well and you have to look mighty hard to see those and I suspect that if I hadn’t told you that it were there you might not even notice them.

Now, not everybody has huge breasts but sometimes they’re just plain saggy and this is a woman who has lovely frame, if you look at her post-operative photograph, you see she’s really very, very fit but those breasts are all you see in that pre-operative photograph, they’re stretched out, they’re halfway to her belly button. And, I’ll confess to you when I saw this patient's post-operative photographs, I had to go back and confirm to myself it was the same person because even I, who had done her surgery, wasn’t 100 % certain. And, you can see that now she has breasts that are higher and they blend in with her body and they really accentuate her beautiful frame.

Moving on to breast augmentation, another thing that happens to women as they get older and they can lose some volume in their breasts and they actually might be okay with the location of their nipples and their areolas but after nursing a couple of kids and going through menopause, the breast tissue has disappeared and so their breasts become quite flat. Now not everybody wants to have full Hollywood breasts or Miami breasts, they really would just like to have a small filling out of the previous breast skin and that's what I did for this patient and she was thrilled with this. I really just added back a little bit of the volume that she had lost and she really still has a B-size breast even though they are augmented.

Moving onto patients who may want to have some more fullness on their upper chest wall, this patient whose breasts are not only asymmetrical, one is larger than the other and one is sitting down lower. And she wanted her breasts to be higher and tighter and she also wanted that fullness on the upper chest wall that was going to give her more fullness in gowns. So in that instance you need to not only fix the skin envelope with the breasts but you do have to add some volume in that includes a breast implant. So, this is a combination of a breast implant plus a breast lift. And, these can be done. In her, I was able to correct the asymmetry that she had before, the left breast is now much more symmetrical with the right and she has beautiful skin and was really very satisfied.

Then, there are patients who........this is the same patient actually, this is just to show you that sometimes people come to me and it’s not just their breasts that are bothering them, between having children, their abdomens have also gotten stretched out and so we are able to correct both their breasts and at the same time correct their abdomens. She has lost both the core strength of her abdomen as well as having extra skin. And that surgery was done simultaneously and on the left side you can see she although she’ll have a scar under that bikini line, it can be hidden but it has given her back the confidence to be able to put a bikini on and go and really enjoy herself and love her body again.

And finally I think everybody should be like Marilyn Monroe in this picture, we should embrace ourselves and embrace our breasts and really wear what she’s showing there that we feel good about ourselves. And, I don't see that after 50, after 60, even 70 year olds, I don't know I probably have even operated on an 80 year old somewhere although less so, but most of us of our generation are going live perhaps until we’re 100 and so the age of 60 , 50 is certainly not a barrier to these surgeries. They can be very safely and well performed in a healthy patient , the recovery period is relatively short and they can be dramatically life changing in terms of your physical fitness as well as your general sense of wellbeing about how you look and how you go through you daily life.